Uncontrollable Post-Ana Recovery Weight Gain

I honestly cannot stop gaining weight. Based on my diet and exercise, I shouldn't be gaining.

I never consume more than 1500 calories per day, and I exercise a lot. I'm strong, I'm in shape, but I keep getting fatter (no, it's not muscle weight). Over the past couple of months, after I recovered from a 5 year bout of anorexia, I have not been able to keep my weight down. I literally went from 83lbs to 145lbs within a year, and I keep going up (I'm 5'4")! I was weighed at my OBGYN last week and was at 153! I broke down in the office (shouldn't have done that), but my doctor didn't seem to even care that I gained nearly 10lbs in a month! I went to the appointment to talk about increasing my thyroid medication, but she took me OFF of it!

So yes. I also have "subclinical" hypothyroidism (TSH 4.1, don't know the other #'s, my doctor wouldn't give me a printout of my bloodworm). I WAS on .25mcg of levothyroixine, but not anymore. I see an actual endocrinologist on the 16th of July, but I'm so nervous I will gain even more weight by then! I just don't know what to do anymore - I look and the mirror and hate what I see more and more every day. I'm so disappointed and disgusted with myself. I work with people every day who are looking to lose weight...and I can help them lose weight, but I can't myself (even though everything I'm doing SHOULD elicit weight loss). I'm totally discouraged.

Just for reference, this is what a typical day of food looks like for me:

As for exercise, I strength train (HEAVY lifting) 4 days per week, I do HIIT training (15-20 minutes) 4 days a week, and I hike for 2 hours 3 days a week (average calorie burn 500 cal per hike). Sunday is my "rest day" but I still take a 4 mile walk if the weather is nice.

Has anyone else ever had this problem? Or better yet...has anyone had any success solving a similar problem?

I am totally not an expert but...maybe your metabolism just needs to reset itself? After 5 years, well, perhaps it will take a while longer for you to settle in to a healthy weight.

Were you working with a doctor or therapist? If so, they would be the best ones to discuss this with. Your gyn, if she is not familiar with your history, may not be the best person to help you.

If you haven't been working with a doctor or a therapist, I would encourage you to start.

My 14yo was treated for an eating disorder last fall. While it turned out to be severe food allergies, including celiac, she had gotten into some very bad eating habits. Her weight is up but she still struggles with eating healthily on a regular basis. We are working with her therapist, a nutritionist, allergist, GI dr and her pediatrician keeps an eye on things.

Thank you for your reply. I am looking for a good endocrinologist to go to. I had some very bad luck with one about 2 weeks ago. I'm thinking of seeing a therapist, but I'm a bit more concerned right now with the physical aspect of weight gain, rather than the mental part (since I really have no desire whatsoever to go back to my anorexic weight, or anything close to it).

As for my GYN, she does know my family history...both my mum and grandmum go there as well...I have no idea why she was so terribly unhelpful.

As for now, I'm just going to keep up with exercising and eating only "clean" food, as I have been. I just don't know why I seem to keep gaining...or how to stop it...because what seems to work for other people doesn't work for me

Do you eat low carb on purpose? Like below 100g/day? You also work out a lot. What might happen is that under long-term low carb conditions, particularly in combination with exercise, you affect the conversion of inactive T4 to active T3 in the liver. Secretion from the thyroid would still be normal, but only accounts for a fraction of active T3. This would therefore not show up in big changes in TSH. It would be necessary to look at a complete panel of your thyroid hormones (I guess free T4, free T3 and rT3 if possible -rT3 is another form of T3, which can still bind the receptor, but is not active). You may also want to test for antibodies (Hashimoto's). If thyroid hormones go down, you affect estrogen/progesterone balance (test?). Weight gain may be due to water retention either because of sex hormone imbalance or because of altered heart function due to thyroid hormone inactivity. You may also look into low T3 syndrome. Stop exercising so much and maybe increase carb intake to above 100g.

I have to disagree with some the advice above. The biggest thyroid issues with weight management are in response to low calories - low carb ad libitum should not create much in the way of symptoms for sub-clinical hypo that's already being managed.

Post starvation fattening is a scientifically observed phenomenon, unfortunately, and more related to adipokines and the hormonal feedback loop relating to energy balance within your cells than diet in general. There are ways to manage that (ketotic state being the best, actually) and essentially circumvent some of the worst of the potential energy mismanagement that could be going on in your sympathetic nervous system - but if you're already fairly metabolically deranged and add a long term eating disorder in there as well, you could be in for a rough time stabilizing below a certain weight.

I'd up your calories on training days, at the very least, and keep all else the same. Investigate with the endocrinologist and do yor own research as well. But my solution for you would be more fat, more calories, less lean protein sources (try something fattier like eggs with butter or sardines), and lower carbs, to really see if it was actually your energy metabolism that is responding strangely, versus something dietary or environmental that you just haven't dialed in yet.

Addendum: I forgot to address that I do agree with Lolo that overtraining is the last thing you need if you're truly showing signs of dopamine insufficiency or high cortisol. If your thyroid is wonky, go VERY gently in any and all physiological changes. Hard exercise could only exacerbate things.

I want to really encourage you on your recovery. And this is just my two cents worth, but I have some personal knowledge about some of the issues you are dealing with and I think a good therapist who is very knowledgable in the are of eating disorders is something that would really help you. Someone you feel comfortable with and whom you click with. It can take some time to find someone good, but it will be worth it. I wish you all the best and keep up the recovery.

__________________Kathy

254/176/174
SW/CW/GW

Restart July 16, 2011

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